Cryosurgical probe with adjustable sliding apparatus

ABSTRACT

A cryosurgical probe that includes a shaft for providing a heat exchange surface for cryogenic ablation, a housing, an insulation element slideably engaged with the shaft, and an adjustable sliding apparatus. The adjustable sliding apparatus includes a slider assembly attached to the insulation element for slideably guiding the insulation element within the shaft, and an actuation assembly operatively connected to the slider assembly for allowing a user to slide the slider assembly to provide a desired adjustment of the insulation element relative to the shaft.

CROSS REFERENCE TO RELATED APPLICATIONS

This is a continuation of U.S. application Ser. No. 12/581,145, entitled“Cryosurgical Probe with Adjustable Sliding Apparatus”, filed on Oct.18, 2009, which is a continuation of U.S. application Ser. No.11/857,095, now U.S. Pat. No. 7,608,071, entitled “Cryosurgical Probewith Adjustable Sliding Apparatus”, filed on Sep. 18, 2007, which is acontinuation of U.S. application Ser. No. 11/685,058, now U.S. Pat. No.7,381,207, entitled “Quick Disconnect Assembly Having a Finger LockAssembly”, filed on Mar. 12, 2007, which is a continuation-in-part ofU.S. application Ser. No. 11/116,873, now U.S. Pat. No. 7,189,228,entitled “Detachable Cryosurgical Probe with Breakaway Handle,” filedApr. 28, 2005 which is a continuation-in-part of U.S. application Ser.No. 10/603,883, now U.S. Pat. No. 7,207,985, entitled “DetachableCryosurgical Probe,” filed Jun. 25, 2003. The entire contents of each ofthe above applications are incorporated herein by reference for allpurposes in their entirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

Embodiments of the present invention relate to cryosurgical probes andmore particularly to cryosurgical probes with an adjustable slidingapparatus to change the size of the resulting iceball.

2. Description of the Related Art

Cryosurgery involving the use of a cryosurgical probe assembliestypically involves the use of cryoprobes that are each attached to ahandle that are, in turn, connected to a high-pressure fluid line with aquick-disconnect for attachment to a fluid source. There is an inherentproblem with this type of system inasmuch as each cryosurgical probeassembly should be used only once due to sterilization and performancefactors. Therefore, typically, the entire cryosurgical probe assemblyand high-pressure fluid line must be discarded after that single use.Due to these sterilization/performance requirements there is a need toassure that the cryosurgical probe assembly may be rendered non-useableafter a single-use.

Previous attempts to mitigate this problem have involved utilizing adisposable sheath over a cryosurgical probe. For example, U.S. Pat. No.5,910,104, issued to J. D. Doback, III et al, discloses a disposable,sterilizable sheath for use on a closed loop Joule-Thomson cryosurgicalprobe, and the combination of the disposable sheath and the closed loopprobe. The sheath is slipped over the probe, thereby separating theprobe from the environment. The sheath has a grip that fits over thehandle of the cryosurgical probe. The sheath has a hollow multi-lumencatheter shaped and sized to fit snugly over the cannula of thecryosurgical probe.

U.S. Pat. No. 6,306,129 B1, issued to Little et al, also discloses theuse of a disposable sheath over a cryosurgical probe.

Similarly, U.S. Pat. Publication US 2002/0022832 A1, to Mikus et al,discloses a cryoprobe assembly that includes a cryoprobe and an outersheath assembly detachably connected thereto.

U.S. Pat. Publication US 2004/0267248 (U.S. Pat. No. 7,207,985), toDuong et al, entitled “Detachable Cryosurgical Probe”, discloses acryosurgical probe system that includes a fluid supply line connectableat an inlet section to a source of cryogenic fluid; a fluid connectorassembly securely connected to an outlet section of the fluid supplyline for receiving fluid from the outlet section of the fluid supplyline; and, a detachable cryosurgical probe detachably connectable to thefluid connector assembly. The cryosurgical probe system includes thecapability of providing return fluid flow.

U.S. Pat. Publication US 2005/0010200 (U.S. Pat. No. 7,160,291), toDamasco et al, entitled “Detachable Cryosurgical Probe”, discloses acryosurgical probe system that includes a fluid supply line connectableat an inlet section to a source of cryogenic fluid; a fluid connectorassembly securely connected to an outlet section of the fluid supplyline for receiving fluid from the outlet section of the fluid supplyline; and, a detachable cryosurgical probe detachably connectable to thefluid connector assembly. The fluid connector assembly includes asubstantially cylindrical lock housing securely attached to the outletsection of the fluid supply line, the lock housing having a fluid inletconduit for receiving high pressure fluid from the fluid supply line anda fluid outlet conduit for transferring return fluid from thecryosurgical probe to the fluid supply line. A locking mechanism ispositioned at a locking portion of the lock housing to providedetachable engagement of a cryosurgical probe positioned therein. Thedetachable cryosurgical probe receives fluid from the fluid connectorassembly and manipulates the fluid to provide suitable temperatures forcryosurgical treatment. It includes a fluid delivery/return manifoldassembly having a fluid delivery section and a return manifold section.The return manifold section is positioned over a portion of the fluiddelivery section. The return manifold section includes an insulativevacuum sleeve. The fluid delivery/return manifold assembly has aproximal end section. An outer sheath is securely positioned over thevacuum sleeve and extends from the fluid delivery/return manifoldassembly. A lock anchor is securely positioned over the outer sheath.The lock anchor provides detachable connection to the fluid connectorassembly of a detachable cryosurgical system. During operation fluid isdelivered through the fluid delivery/return manifold assembly, through aJoule-Thomson (J-T) port defined at a distal end of the fluid deliverysection and is returned through the return manifold section anddelivered out of the cryosurgical probe. The insulative vacuum sleeve isprovided between the outer sheath and the return manifold section at acontrol region of the outer sheath proximal to a distally locatedtreatment region of the outer sheath. Unlike previous cryosurgical probesystems, the operative portion of the present system, i.e. thedetachable cryosurgical probe, can be discarded after a single use.However, the fluid supply line and the connector assembly can be reused.The cryosurgical probe system includes the capability of providingreturn fluid flow. Suitable passageways in the detachable cryosurgicalprobe and the fluid connector assembly provide this feature.

U.S. Pat. No. 5,978,697, issued to Maytal, et al, discloses anMRI-guided cryosurgical system. The Maytal system includes: (a) an MRImagnet for accommodating a patient, the MRI magnet having at least oneopening for enabling access of a surgeon to the patient, the MRI magnetincluding at least one channel extending therethrough for receiving aline member of a surgical device; (b) a surgical device, including: (i)an operating member for operating the patient; (ii) a control member forcontrolling the operating member, the control member being positionedexternally to the MRI room; and, (iii) a line member having a first endconnectable to the operating member and a second end connectable to saidcontrol member, wherein at least a portion of the line member isreceived within the channel of the MRI magnet.

SUMMARY OF THE INVENTION

In a broad aspect, one embodiment of the present invention is directedto a cryosurgical probe comprising a shaft for providing a heat exchangesurface for cryogenic ablation, a housing, an insulation elementslideably engaged with the shaft, and an adjustable sliding apparatus.The adjustable sliding apparatus comprises a slider assembly attached tothe insulation element for slideably guiding the insulation elementwithin the shaft, and an actuation assembly operatively connected to theslider assembly for allowing a user to slide the slider assembly toprovide a desired adjustment of the insulation element relative to theshaft.

In another broad aspect, an embodiment of the present invention isdirected to a cryosurgical probe assembly comprising a housingcontaining at least a portion of a fluid conduit subassembly, where thefluid conduit subassembly is for delivering and returning cooling fluidthat is used for cryogenic cooling. The fluid conduit subassemblycomprises a shaft for providing a heat exchange surface for cryogenicablation and an insulation element slideably engaged with the shaft. Thecryosurgical probe assembly also includes (i) an adjustable slidingapparatus having a repositionable slider assembly attached to theinsulation element for slideably moving the insulation element withinthe shaft to provide a desired adjustment of the insulation elementrelative to the shaft, and (ii) a cryostat.

Further, another embodiment of the present invention is directed to acryosurgical probe assembly comprising a gas delivery assembly includinga fluid conduit subassembly where the fluid conduit subassembly includesa shaft for providing a heat exchange surface for cryogenic ablation, ahousing securely connected to the shaft, and an insulation elementslideably engaged with the shaft. The cryosurgical probe assembly alsocomprises a handle assembly and an adjustable sliding apparatus having(i) a slider assembly securely attached to the insulation element forslideably guiding said insulation element along the shaft, and (ii) ameans for allowing a user to actuate the slider assembly to provide adesired adjustment of the insulation element relative to the shaft.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective illustration of a first embodiment of thedetachable cryosurgical probe with the disposable probe assemblyattached to the reusable probe assembly.

FIG. 2 is perspective illustration of the FIG. 1 embodiment of thedetachable cryosurgical probe shown with the disposable probe assemblydetached from the reusable probe assembly.

FIG. 3 is a cross-sectional view of the disposable probe assembly shownattached to the reusable probe assembly, the view being broken away in afew sections to emphasize the showing of the attaching portions of thedetachable cryosurgical probe.

FIG. 4 is a cross-sectional view showing respective attaching portionsof the disposable probe assembly and the reusable probe assembly, in adetached configuration.

FIG. 5 is an enlarged cross-sectional view showing respective attachingportions of the disposable probe assembly and the reusable probeassembly, in an attached configuration.

FIG. 6 is a view taken along line 6-6 of FIG. 5.

FIG. 7 is a view taken along line 7-7 of FIG. 5.

FIG. 8 is an enlarged perspective view of the portion of detachablecryosurgical probe where the detachment takes place.

FIG. 9 shows an initial stage of detachment wherein the breakawaysurfaces are detached.

FIG. 10 shows an intermediate stage of detachment showing relativecounter rotation of the disposable probe assembly and the reusable probeassembly.

FIG. 11 shows the counter rotation resulting in relative axial motion ofthe disposable probe assembly and the reusable probe assembly.

FIG. 12 is a perspective view of the breakaway collar of the presentinvention.

FIG. 13 is a cross-sectional view of the detachable cryosurgical probejust after the breakaway collar has been detached.

FIG. 14 is a cross-sectional view of the detachable cryosurgical probeat the intermediate stage of detachment when the fingers are opening.

FIG. 15 is a cross-sectional view of the detachable cryosurgical probeat the final stage of detachment when the fingers have openedsufficiently to enable the disposable probe assembly to be detached fromthe reusable probe assembly.

FIG. 16 is a side perspective view of a portion of an alternateembodiment of the detachable cryosurgical probe in which the vacuum tubemay be repositioned as desired relative to the shaft, the vacuum tubebeing in a first position.

FIG. 17 is a front perspective view of the detachable cryosurgical probeof FIG. 16 in the first position and including a showing of the shafttip.

FIG. 18 shows the detachable cryosurgical probe of FIG. 16 in a second,extended position.

FIG. 19 is a cross-sectional view of the detachable cryosurgical probeof FIG. 16 in the first position.

FIG. 20 shows the detachable cryosurgical probe being moved between twopositions.

FIG. 21 shows the detachable cryosurgical probe moved to a secondposition.

The same elements or parts throughout the figures are designated by thesame reference of characters.

DETAILED DESCRIPTION OF THE INVENTION

Referring now to the drawings and the characters of reference markedthereon, FIG. 1 illustrates a preferred embodiment of the detachablecryosurgical probe of the present invention, designated generally as 10.The detachable cryosurgical probe 10 includes a disposable probeassembly, designated generally as 12 and a reusable probe assembly,designated generally as 14. The reusable probe assembly 14 includes afluid supply line 16 that is connected at an inlet section 18 to asource (not shown) of cryogenic fluid. The fluid source may be, forexample, a cryosurgical system such as that manufactured by presentassignee, Endocare, Inc., Irvine, Calif. Such a cryosurgical systemtypically utilizes argon gas from an argon gas source to provideJoule-Thomson cooling of the cryosurgical probes. Alternatively,nitrogen can be used. Alternatively, a fluid supply system can beutilized that does not require an external fluid supply source. Heatingof the cryosurgical probes is typically provided by a helium gas sourcefor providing a helium gas flow through the Joule-Thomson nozzle of thecryosurgical probe. This provides a heating effect. Such heating of thecryosurgical probes is provided to unstick the probes from the treatedtissue for cryoprobe removal. A gas delivery assembly of the disposableprobe assembly 12 includes a shaft 20 that has a freezing zone. Spacedmarkings 21 may be provided on the outer surface of the cryosurgicalprobe 10. These markings 21 may be, for example, at 1 cm intervals.

FIG. 2 shows the disposable probe assembly 12 detached from the reusableprobe assembly 14, as will be described in detail below.

Referring now to FIG. 3, the disposable probe assembly 12 is shownattached to the reusable probe assembly 14. This figure is broken awayin a few places for the purposes of clarity. The disposable probeassembly 12 includes a gas delivery assembly 22, a finger lock assemblyincluding finger lock element 24, and a disposable handle assembly 26.The gas delivery assembly 22 includes a stem 28 and a fluid conduitsubassembly 30 bonded to the stem 28. The fluid conduit subassembly 30is for delivering and returning cooling fluid used for cryogeniccooling. The finger lock element 24 includes a distal finger lockelement section 32 (see also FIG. 6) having a threaded inner surface forengagement with a threaded outer surface of the stem 28. Four radiallyspaced fingers 34 (see also FIG. 7) extend proximally from the distalfinger lock element section 32. Each finger 34 has a ramped surface 36for operatively engaging an associated ramp section on the stem 28during use; and, a female lip 38 at a proximal end thereof.

The disposable handle assembly 26 includes a proximal handle section 40,a distal handle section 42; and, a breakaway collar 44. The proximalhandle section 40 has a distal end having an inner surface that isoperatively engaged with an outer surface of the finger lock element 24(this region of engagement designated 46) so as to resist relativerotation and axial motion therebetween. As can be seen in FIG. 6, hexshaped surfaces are utilized to prevent relative rotation; however,obviously other geometric shapes and other means can be used to preventsuch rotation such as radial bumps, pins, etc.

The distal handle section 42 of the disposable handle assembly 26 has aninner surface that is operatively engaged with another outer surface ofthe stem 28 (this region of engagement designated 48) so as to resistrelative rotation and axial motion therebetween. Again, this region ofengagement may be hex shaped. The breakaway collar 44 is positionedbetween the proximal handle section 40 and the distal handle section 42.

The fluid conduit subassembly 30 includes a Joule-Thomson (J-T) tube 50bonded to the stem 28. It may be welded thereto, as shown by numeraldesignation 52. The J-T tube 50 receives the cooling fluid from thereusable probe assembly 14. The distal end of the J-T tube 50 comprisesa J-T nozzle 54. A safety washer 56 is positioned within a front end ofan elongated central opening 58 of the distal handle section 42 of thedisposable handle assembly 26.

A shaft 60 of the fluid conduit subassembly 30 is secured to the safetywasher 56 within an opening of the safety washer 56 and within theelongated central opening 58. The shaft 60 extends beyond the distalhandle section 42 to provide a cooling surface for cryogenic cooling. Inthis embodiment a vacuum tube 62 is integrally connected with an innersurface of the shaft 60. (As will be disclosed below in anotherembodiment there may alternatively be a slideable connection.) A highpressure seal comprising a high pressure o-ring 63 is positioned about aproximal end section of the stem 28 for sealing cooperation (as shown bynumeral designation 64 in FIG. 5) with an inner surface of a manifoldassembly 66 of the reusable probe assembly 14. The vacuum tube 62 has adesired insulative air gap formed therein. The air gap provides selectednon-cooling areas of the cryosurgical probe.

Referring now to FIG. 4, the reusable probe assembly 14 includes themanifold assembly 66 and a reusable handle assembly 68 secured about theperiphery of the manifold assembly 66. The reusable handle assembly 68includes a first end portion 67 and a second end portion 69. Themanifold assembly 66 includes an outer covering 71.

The reusable probe assembly preferably includes a safety valve assembly,designated generally as 70, operatively engaged with the manifoldassembly 66 for impeding cryogenic working fluid flow when thedisposable probe assembly 12 is detached from the reusable probeassembly 14. The safety valve assembly 70 includes a conical surface 72formed in a proximal penultimate section 74 of a proximal end portion ofthe manifold assembly 66. The manifold assembly 66 terminates, at itsproximate end, with a proximal ultimate section 76. The proximalultimate section has a ball retaining cavity 78 formed therein. A ball80 is positioned within the ball retaining cavity 78. The function ofthis safety valve assembly 70 will be discussed below in detail.

The reusable probe assembly also preferably includes an electricalconfirmation assembly, designated generally as 82, operatively engagedwith the disposable probe assembly 12 for providing electricalconfirmation that the disposable probe assembly 12 is connected. Theelectrical confirmation assembly 82 includes a slideable electricallyconductive ring 84 positioned about an outer surface of the reusableprobe assembly 14 and normally distally biased by a spring 86. Theelectrical confirmation assembly 82 includes stationary electricallyconductive lever spring contact 88 and plastic housing 89 for the leverspring contact 88. The lever spring contact 88 is electrically connectedto the cryosurgical system by wires 85. The function of this electricalconfirmation assembly 82 will be discussed below in detail.

In operation, when the disposable probe assembly is attached, as can beseen in FIGS. 5, 8, and 12 the breakaway collar 44 is an integral unitthat prevents relative rotation between the proximal handle section 40and the distal handle section 42. In this configuration, the female lip38 engages a male lip 90 of the manifold assembly 66; thereby securingthe reusable probe assembly 12 to the disposable probe assembly 14.

Referring now to FIGS. 9 and 13, during an initial stage of detachmentof the disposable probe assembly, the user rotates the distal handlesection in a first direction relative to the proximal handle section to“break away” breakaway surfaces of the breakaway collar 44, allowing thebreakaway collar 44 to radially expand. In FIG. 13 the breakaway collar44 is shown removed; however, during actual operation it may possiblydangle at that location.

Referring now to FIGS. 10 and 14, during an intermediate stage ofdetachment of the disposable probe assembly 12 the user counter rotatesthe distal handle section 42 in an opposite second direction relative tothe proximal handle section 40. The relative rotation between the distalhandle section 42 and the proximal handle section 40 provides axialmovement of the distal handle section 42 toward the proximal handlesection 40 via the engagement of the threaded inner surface of thedistal finger lock element section 32 and the threaded outer surface ofthe stem 30. The axial movement is enabled by the radial expansion ofthe breakaway collar 44. The ramped surfaces 36 of the radially spacedfingers 34 engage the associated ramp section on the stem 30 during theaxial movement thereby urging the fingers 34 to open.

Referring now to FIGS. 11 and 15, during a final stage of detachment,the fingers 34 open sufficiently to allow disengagement of the male lip90 from the female lip 38, thus enabling the disposable probe assembly14 to be detached from the reusable probe assembly 12.

As mentioned above, the safety valve assembly 70, is operatively engagedwith the manifold assembly 66 for impeding cryogenic working fluid flowwhen the disposable probe assembly 12 is detached from the reusableprobe assembly 14. As can be seen in FIG. 15, when the disposable probeassembly 12 is detached from the reusable probe assembly 14 and nocooling gas is flowing within manifold assembly 66, the ball 80 is freeto float freely within the ball retaining cavity 78. However, when thedisposable probe assembly 12 is detached from the reusable probeassembly 14 and cooling gas is flowing within the manifold assembly 66(as indicated by arrow 92), the ball 80 is urged into a volume definedby the conical surface 72, thus providing sufficient sealing to prevent“whipping” of the disposable probe assembly 12. As perhaps best seen inFIG. 5, when the disposable probe assembly 12 is connected to thereusable probe assembly 14 the Joule-Thomson (J-T) tube 50 bonded to thestem 28 maintains the ball 80 in a position away from the conicalsurface 72, thus allowing the free flow of cooling gas 92 into thedisposable probe assembly 12.

As mentioned above, and referring again to FIG. 4, an electricalconfirmation assembly, designated generally as 82, is operativelyengaged with the disposable probe assembly 12 for providing electricalconfirmation that the disposable probe assembly 12 is connected. Whenthe disposable probe assembly 12 is not connected, the conductive ring84 is not in contact with the lever spring contact 88. When thedisposable probe assembly 12 is connected, the conductive ring 84 isurged by the disposable probe assembly 12 in a proximal direction sothat it contacts the lever spring contact 88 providing a closedelectrical circuit and electrical confirmation of the connection.

A heat exchanger or cryostat 94 is utilized to provide heat exchangebetween inlet gas and outlet gas. Although, as shown, the heat exchangeris preferably a coiled fin tube heat exchanger various other types ofheat exchangers may be utilized such as a tube-in-tube sinteredcryostat, threaded cryostat, coiled/sintered cryostat, or stacked coilcryostat. These different types of cryostats are disclosed and claimedin U.S. application Ser. No. 10/828,031 (U.S. Pat. No. 7,160,291),entitled Detachable Cryosurgical Probe, filed on Apr. 20, 2004,incorporated herein by reference in its entirety.

Referring now to FIGS. 16-21 a second embodiment of the detachablecryosurgical probe system is illustrated, designated generally as 100.In this system 100 the vacuum tube may be repositioned as desiredrelative to the shaft. This is accomplished by actuating a buttonassembly, designated generally as 102, along a guideway 104. FIGS. 16and 17 show the vacuum tube in a first position (i.e. labeled P5). FIG.18 shows the vacuum tube moved to a second position (i.e. labeled P2).

Referring now to FIG. 19, the button assembly 102 can be seen incross-section in the first position. A button 104 of the button assembly102 is biased by a spring 106. A slider assembly 108 is mechanicallyconnected to the vacuum tube 110 and to the button assembly 102. Thus,the shaft 112 and the vacuum tube 110 are capable of moving relative toeach other. The button assembly 102 can be locked into position toprevent unintentional movement. A safety washer assembly 114 is securelyconnected to the shaft 112. It includes an o-ring 116 for sealing theshaft 112 and the vacuum tube 110. Another o-ring 118 at the front ofthe stem 120 seals the vacuum tube 110 and stem 120.

Referring now to FIG. 20, the vacuum tube 110 is shown having been movedtoward a second position relative to the shaft 112 by the actuation ofbutton assembly 102. Referring now to FIG. 21, the button assembly 102is shown moved to position P4. Thus, the size and shape of the generatediceball can be varied in accordance with a specific desired need.

The slider assembly 108 and button assembly 102 are collectively anadjustable sliding apparatus. The vacuum tube 110 serves as aninsulation element.

During operation, with the disposable probe assembly 12 attached to thereusable probe assembly 14, cryogenic fluid originating from (typically)an argon tank flows through the supply line 16 within the cryostat 94and through the manifold assembly as shown by arrow 92 (in, for example,FIG. 5). The flow is directed through the safety valve assembly 70 andthen through the central passageway in the high pressure stem 28 via J-Ttube 50, and out of the J-T port 54 (see FIG. 3).

After being expelled from the J-T port 54 the return fluid is directedin the space between the inner surface of the vacuum tube 62 and theouter surface of the J-T tube 50. It then flows through openings in themanifold assembly 66, as indicated by arrow 114 (FIG. 5) and adjacent tothe heat exchanger 94. The return fluid is eventually expelled via thehose 16.

In the device illustrated the cryosurgical probe is shown with a pointedtip to provide insertion into the patient's tissue for the desiredapplication. However, it is understood that the tip may be blunt,depending on the application. For example, for certain applicationsdirect insertion is desirable. For other applications, insertion via acannula/introducer is preferred.

Although application of this device utilizing CT guidance is preferred,the cryosurgical probe 10 may be used with a variety of guidance tools,such as MRI and ultrasound. In one preferred implementation ultrasoundis used for initial guidance, followed up with CT for finalconfirmation.

Although the present invention has been discussed above with respect toa cryosurgical probe having a rigid outer sheath, the cryosurgical probemay be made to be malleable by including at least one malleable segmentthereon. Malleable segments are formed of material that permit reshapingand bending to reposition the ablating surface for greater ablationprecision. An example of a cryosurgical probe having malleablecharacteristics is disclosed and claimed in our co-pending patentapplication Ser. No. 09/957,337, Pub. No. US 2003/0055415 A1, filed onSep. 20, 2001 (U.S. Pat. No. 6,936,045) entitled Malleable CryosurgicalProbe, incorporated in its entirety herein by reference.

One method for providing malleable characteristics includes providing amalleable shaft with a bellows portion. U.S. Pat. No. 6,767,346, filedon Jul. 27, 2002 entitled Cryosurgical Probe With Bellows Shaft,incorporated in its entirety herein by reference, discloses use of abellows portion for providing the necessary reshaping and bending.

If the detachable cryosurgical probe is utlilized in combination withultrasound the outer sheath may have an echogenic coating with, forexample, a porous microstructure having the ability to trap microscopicair bubbles. This creates thousands of highly efficient ultrasoundreflectors on the surface of the sheath.

Thus, while the preferred embodiments of the devices and methods havebeen described in reference to the environment in which they weredeveloped, they are merely illustrative of the principles of theinvention.

For example, even though the finger lock element has been describedspecifically with respect to the present cryosurgical probe it isunderstood that it can be used on other types of cryosurgical probesthat, for example, may not be single use. Further, the finger lockelement may be used for many applications which require a quickdisconnect (both single use and multiple use). These may include, forexample, control valves for water heaters, pneumatic systems forcontrols that require quick disconnects, electrical connectors, etc.

Although the cryostat 94 has been shown positioned within the manifoldassembly 66 it may be positioned in other locations, notably, forexample, in the hose 16 or within the fluid source.

Although the cryosurgical probe system is particularly advantageous forprostate cryosurgery it is also advantageous for many other types ofablation applications, such as radiological applications.

Other embodiments and configurations may be devised without departingfrom the spirit of the invention and the scope of the appended claims.

1. A cryosurgical probe comprising: a) a shaft for providing a heatexchange surface for cryogenic ablation; b) a housing; c) an insulationelement slideably engaged with the shaft; and d) an adjustable slidingapparatus comprising: i. a slider assembly attached to the insulationelement for slideably guiding the insulation element within the shaft;and ii. an actuation assembly operatively connected to the sliderassembly for allowing a user to slide the slider assembly to provide adesired adjustment of the insulation element relative to the shaft. 2.The cryosurgical probe of claim 1, wherein the adjustable slidingapparatus comprises a button assembly.
 3. The cryosurgical probe ofclaim 2, wherein the button assembly is operatively connected to theslider assembly for allowing a user to actuate the slider assembly toprovide the desired adjustment of the insulation element.
 4. Thecryosurgical probe of claim 2, wherein the button assembly is configuredto be locked into position to prevent unintentional movement of theslider assembly.
 5. The cryosurgical probe of claim 1, wherein theadjustable sliding apparatus permits a user to change a size of aniceball created by the cryosurgical probe.
 6. The cryosurgical probe ofclaim 1, wherein the insulation element comprises a vacuum tube.
 7. Thecryosurgical probe of claim 1, wherein the cryosurgical probe furthercomprises a cryostat.
 8. A cryosurgical probe assembly comprising: a) ahousing containing at least a portion of a fluid conduit subassembly,the fluid conduit subassembly for delivering and returning cooling fluidused for cryogenic cooling, the fluid conduit subassembly comprising: i)a shaft for providing a heat exchange surface for cryogenic ablation;and ii) an insulation element slideably engaged with the shaft; b) anadjustable sliding apparatus, having a repositionable slider assemblyattached to the insulation element for slideably moving the insulationelement within the shaft to provide a desired adjustment of theinsulation element relative to the shaft; and c) a cryostat.
 9. Thecryosurgical probe assembly of claim 8, wherein the adjustable slidingapparatus further comprises a button assembly operatively connected tothe slider assembly for allowing a user to actuate the slider assemblyto provide the desired adjustment of the insulation element.
 10. Thecryosurgical probe assembly of claim 9, wherein the button assembly isconfigured to be locked into position to prevent unintentional movementof the slider assembly.
 11. The cryosurgical probe assembly of claim 8,wherein the insulation element comprises a vacuum tube.
 12. Thecryosurgical probe assembly of claim 8, wherein the cryosurgical probeassembly further comprises a handle assembly.
 13. A cryosurgical probeassembly comprising: a) a gas delivery assembly including a fluidconduit subassembly, the fluid conduit subassembly comprising: i. ashaft for providing a heat exchange surface for cryogenic ablation; ii.a housing securely connected to the shaft; and, iii. an insulationelement slideably engaged with the shaft; b) an adjustable slidingapparatus, comprising: i. a slider assembly securely attached to theinsulation element for slideably guiding said insulation element alongthe shaft; and ii. a means for allowing a user to actuate the sliderassembly to provide a desired adjustment of the insulation elementrelative to the shaft; and c) a handle assembly.
 14. The cryosurgicalprobe assembly of claim 13, wherein the means for allowing the user toactuate the slider assembly comprises a button assembly operativelyconnected to the slider assembly.
 15. The cryosurgical probe assembly ofclaim 14, wherein the button assembly is configured to be locked intoposition to prevent unintentional movement of the slider assembly. 16.The cryosurgical probe assembly of claim 13, wherein the insulationelement comprises a vacuum tube.
 17. The cryosurgical probe assembly ofclaim 13, wherein the cryosurgical probe assembly is detachable.
 18. Thecryosurgical probe assembly of claim 13, wherein the fluid conduitsubassembly includes a Joule-Thomson (J-T) tube.
 19. The cryosurgicalprobe assembly of claim 18, wherein the Joule-Thomson (J-T) tubecomprises a Joule-Thomson (J-T) port.
 20. The cryosurgical probeassembly of claim 13, wherein the adjustable sliding apparatus permits auser to change a size of an iceball created by the cryosurgical probeassembly.